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Acute bacterial prostatitis

Alain Meyrier, MD
Thomas Fekete, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


The prostate is subject to various inflammatory disorders [1]. One of these syndromes is acute bacterial prostatitis, an acute infection of the prostate, usually caused by gram-negative organisms [2]. The clinical presentation is generally well defined, and antimicrobial therapy remains the mainstay of treatment [3].

Acute bacterial prostatitis will be reviewed here. Chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome are discussed in detail elsewhere. (See "Chronic bacterial prostatitis" and "Chronic prostatitis/chronic pelvic pain syndrome".)

Other causes of dysuria in men, including cystitis, urethritis, and epididymitis, are also discussed elsewhere. (See "Acute uncomplicated cystitis and pyelonephritis in men" and "Urethritis in adult men" and "Evaluation of acute scrotal pain in adults", section on 'Acute epididymitis or epididymo-orchitis'.)


Entry of microorganisms into the prostate gland almost always occurs via the urethra. In most cases, bacteria migrate from the urethra or bladder through the prostatic ducts, with intraprostatic reflux of urine (figure 1). As a result, there may be concomitant infection in the bladder or epididymis. Uropathogenic bacterial isolates that cause prostatitis may have a higher accumulation of specialized virulence factors than those involved in cystitis alone [4,5].

Acute prostatitis can also occur from direct inoculation after transrectal prostate biopsy and transurethral manipulations (eg, catheterization and cystoscopy) [6,7]. (See "Prostate biopsy", section on 'Infection'.)

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Literature review current through: Nov 2017. | This topic last updated: Oct 11, 2017.
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